Abstract

Diabetes control is poor in children in the UK compared with most European countries; only 17% of children achieve HbA1c levels less than the target value of 7.5% [1]. Historically we have tended to use insulin regimens requiring twice-daily injections (before breakfast and before the evening meal) meaning that children did not generally require an insulin injection or blood glucose check during the school day. However, the majority of large centres in this country and most in Europe are now using insulin regimens which are more physiological and have the potential of improving glycaemic control when used intensively; multiple injection therapy (MIT) and continuous subcutaneous insulin infusions (insulin pumps). Both require much greater input throughout the day as insulin is required at every meal-time, and, in order to improve control further, the dose of insulin must be related to the carbohydrate content of the meal, and to the prevailing blood glucose level.

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